[Portal hypertension - surgery during childhood (author's transl)].

Portal hypertension in children and infants is rare. It is caused in 75% of the cases by prehepatic obstruction of the portal vein, liver parenchyma being essentially unimpaired. Thus most of these cases may be cured, if the pathological hemodynamic situation can be corrected. The nature and extent of pathologic changes vary widely, thus the surgical approach has to be rather individual. The most important aim is to avoid esophageal bleeding but more has to be done to cure the underlying disease. 50 different surgical approaches have been described; when selecting one of these it has to be taken into account if and to what extent portal pressure has to be lowered, and how portal venous and hepatic arterial blood flow are to be influenced.